HDU/SOP/QA/FM04-CF
CUSTOMER FEEDBACK FORM
Human Diagnostics Uganda Limited - Quality Assurance Department
Takes about 2 minutes to fill in this form
Facility Name
District
This form came with:
Please fill in the Facility Name.
Please fill in the District Name.
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Delivery Note
Tax Invoice
Job Card
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** Please fill in as applicable, to you:
Were the products / equipment received in good condition?
Consider: packaging, completeness, correct items, no visible damage.
Yes:
No:
Was the service or repair work done to your satisfaction?
Consider: quality of work, whether the fault was resolved, engineer's conduct.
Yes:
No:
Did HDUL respond to your concern or query within an acceptable time?
If this is your first interaction, you may skip this.
Yes:
No:
If none of the above apply to you, please give us feedback on how our products are performing, as well as the quality of services received from Human Diagnostics Uganda.
Be as specific as you like.
For better understanding, an attachement in the form of a PDF, PNG or JPEG format might be helpful.
Upload attachement below. Optional: Upload PDF, JPG, PNG
If this is a complaint, how urgent is it?
Critical:
Patient / equipment safety
High:
Major service disruption
Medium:
Needs follow-up
Low:
Suggestion only
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consent to Human Diagnostics Uganda's Quality Assurance Department using this feedback to improve our services.
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prefer to remain anonymous.
Your feedback goes directly to our QA team and is treated with full confidentiality.
